CANCER :
EPIDEMIOLOGY OF
LUNG CANCER
NAME : MUKESH KUMAR
ROLL NUMBER : 87
BATCH : 2020
DEPARTMENT OF COMMUNITY MEDICINE
CONTENTS
Introduction
Global lung cancer incident and mortality
Epidemiological features
Age and sex
Risk factors
Prevention
Primary prevention
Secondary prevention
INTRODUCTION
Lung cancer has been known in industrial workers from
late 19 century.
It came into prominence as a public health problem in
western world in 1930s.
At first in man and later (in 1960s) among women and
has followed the increase adaption of cigarette smoking
first by men and later by women.
ACCORDING TO WHO REPORTS
BETWEEN 1960 AND 1980
The death rate due to lung cancer increase by 76% in
men.
By 135% in women.
In country where cigarette smoking has recently begin to
be widely adapted, lung cancer death still remain low but
may be expected that they will rise soon.
The total burden of lung cancer in our country is directly
related to the amount and duration of cigarette smoking.
INDIAN LUNG CANCER
INCIDENTS
In India, the age standardized incidence rate for year 2022
was
total : 8.4 per 100,000 population
for man : 7.8 per 100,000 population
for women : 3.1 per 100,000 population
• The estimated deaths were 66,279.
• The rate was 4.9 per 100,000 population.
EPIDEMIOLOGICAL FACTORS
A .AGE AND SEX
In many industrialized countries the incidence of
lung cancer is at present increasing more in women than in
males
B. RISK FACTOR
1. Smoking
The study in India that the lung cancer risk for cigarette
smokers is 8.6 times the risk of non smokers.
CONTINUE…
The risk is strongly related to
Number of cigarette smoked
Smoking habits such as inhalation
Number of puffs
Nicotine content
Tar content
Length of cigarettes
CONTINUE…
• Those who are highly exposed to “passive smoking” are
at the increase risk of developing lung cancer.
• Bidi smoking appear to carry a higher lung cancer risk
than cigarette smoking owing to the higher
concentration of carcinogenic hydrocarbon in the
smoke.
CONTINUE…
The most noxious component of tobacco smoking are tar,
carbon monoxide and nicotine.
The carcinogenic role of tar is well established.
Nicotine and carbon monoxide contribute to increase risk
of
Cardiovascular disease
Interference with Myocardial oxygen delivery
Reduction of the threshold for ventricular fibrillation.
A study in India has shown that there is no difference
between tar and nicotine delivery of filter and non filter
cigarettes smoked in India, so that a filter gives no
protection to Indian smokers.
The “king-size” filter cigarette deliver more tar and
nicotine than ordinary cigarette.
II. OTHER FACTORS:
Air pollution
Radioactivity
Occupation exposure to asbestos, arsenic and its
compound, etc.
PREVENTION
1. PRIMARY PREVENTION
In lung cancer control, primary prevention is of
greater importance.
The most promising approach is to control the “smoking
epidemic”, because 80-90% of all lung cancer in developed
countries are due to smoking of cigarettes.
The methods of controlling the smoking epidemic has been
described by WHO expert committees in their reports.
CONTINUE…
Broadly these methods include:
Public information and education
Legislative and restrictive measures
Smoking cessation activities
National and international coordination
PUBLIC INFORMATION AND
EDUCATION
Create public awareness about the hazards of smoking
through mass media.
Target population should be entire population with
greater emphasis lead on young people and school
children.
National anti smoking campaign
Curtailment of smoking must be an essential part of
health policy.
LEGISLATIVE AND RESTRICTIVE
MEASURES
Legislative and restrictive measure have been suggested in
the following areas:
Control of sales promotion
Health warning on cigarette packet and ads.
Product description showing yield of harmful substances.
Imposition of upper limits for harmful substances in
smoking material.
Restriction on smoking in public places.
Restriction on smoking in place of work.
Sales restriction
SMOKING CESSATION ACTIVITIES
In all countries well over 90% of those who give up
smoking do so of there own volition, i.e., without use of
any specific therapy.
Basic role of most treatment for smoking cessation would
to be leave the smoker of “abstinence symptoms” (eg:
sleeplessness, craving for smoking, dizziness, constipation
etc.)
Smoking cessation methods:
Smoking cessation clinics
Nicotine substitutes
Hypnosis, etc.
NATIONAL AND INTERNATIONAL
COORDINATION
Since smoking is a world wide epidemic, it requires
coordinated political and non political approach at local,
national and international levels to contain the smoking
epidemic.
2. SECONDARY PREVENTION
This rests on early detection of cases and their treatment.
At present only two procedure capable of detecting pre
symptomatic, early stage of lung cancer. These are:
Chest X ray
Sputum cytology
But screening for early stage lung cancer is less attractive,
expensive and appears to have less potential for reducing
mortality than primary prevention.
CONTINUE…
Therefore, mass screening for lung cancer is not
recommended as a routine as a public health policy.
Effort to find effective treatment for lung cancer have met
with only limited success.
For untreated patient
median survival is 2-3 months.
Patient receiving combined chemotherapy
median survival is 10-14 months.
An important part of
treatment is relief of pain
so that each dying patient
has the right to spend his
last days as pain free as
possible.
BIBLIOGRAPHY
PARK’S TEXTBOOK OF PREVENTIVE
AND SOCIAL MEDICINE
- K. PARK
(27th
edition)
THANK YOU
